SUMMARY/ABSTRACT: CLINICAL CORE (CORE B) The primary goals of the Emory ADRC Clinical Core are to support and enhance research efforts to understand the causes of Alzheimer's disease and related neurodegenerative disorders in order to develop effective treatments. To accomplish these goals, the Clinical Core maintains a cohort of volunteers who allow investigators to examine the process of normal and pathological cognitive aging, provide essential biological specimens and neuroimaging data, and serve as participants in promising clinical trials. The Clinical Core contributes to local, national, and international studies and reflects NIA-defined network-wide priorities. In the current funding period, the Core has provided top-quality clinical data and biological samples to national coordinating centers, and has maximized community engagement and participation of African-American older adults in ADRC-sponsored research and related projects. Specific Aims for this renewal are to 1) continue to maintain a cohort of well-characterized participants to support efforts to understand normal cognitive aging and decline due to AD and related disorders; 2) develop innovative approaches to increase the participation of African Americans in AD research; and 3) establish a Longitudinal Biomarker Collection to support research and improve understanding of the early stages of pathological cognitive aging. We will focus our efforts on preclinical disease and mild cognitive impairment since treatments are more likely to be successful if implemented at an early stage. We also plan to double the current cohort to include 50% African Americans to address stark racial imbalances in understanding clinical, pathological, and genetic features of AD and to make data available for multicenter studies. As part of this effort, we will collect data to define elements that improve success in recruiting and engaging African-American research volunteers. Longitudinal biomarker sampling of blood, CSF, and neuroimaging will provide a powerful resource since cross-sectional studies limit our ability to identify predictors of AD onset and progression. The themes and goals that are proposed for the Clinical Core are consistent with the overall focus of the Emory ADRC, and it will serve as a powerful proponent for basic and clinical research efforts to advance our abilities to diagnose and treat patients suffering from AD and other neurodegenerative dementing diseases.